Individual
LORRAINE AMANDA BECERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, PHD, LBA
Contact information
Practice address
205 PORTLAND ST, COLUMBIA, MO 65201-6521
(573) 884-4642
Mailing address
205 PORTLAND ST, COLUMBIA, MO 65201-6521
(573) 884-4642
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
95203282506
UT
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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